This is an application for renewal of the Johns Hopkins University School of Medicine Medical Scientist Training Program, now in its 34th year. The Program seeks to train MD-PhD students for positions of leadership in academic medicine and medical research. Since our last submission in 2004, applications have continued to be very high, averaging 534 per year. Interviews are extended to approximately 15% of those applicants who complete the Hopkins secondary application. Applicants invited for interviews have outstanding academic records (mean GPA 3.9), excellent MCAT scores (average total 37), significant laboratory research experience, and high motivation for careers in biomedical research and clinical medicine. Approximately 10-12 students enter the Program annually and on average 10 students receive MSTP awards. The average length of study for the combined degrees is 7.8 years. There are currently 98 students in the Program; 81 have MSTP awards and 4 have individual NRSA awards. Currently, 28% of the students are from groups underrepresented in medicine. Students typically complete two years of preclinical medical school courses before enrolling in a graduate program for 3-4 years. Students can select a mentor from a graduate faculty of 996 investigators in 27 graduate programs. During PhD training, students take advanced courses and complete thesis research, publishing an average of 6.2 peer-reviewed papers, before returning to complete the required clinical clerkships and electives. The MSTP Director is a Johns Hopkins faculty member who is also an active investigator. The Director heads a 36-member MD-PhD Committee that admits applicants and formulates policies for the Program. Since the inception of the Program, 286 MD-PhD students have graduated, 216 with MSTP support. Of the 286 graduates, 226 have completed postgraduate training and begun their careers. Of these, 88% are in medical research positions. This includes those in academic medicine (69%), those at research institutes such as the NIH (7%) and those in the pharmaceutical or biotech industries (12%). Thus, the Program is fulfulling its mission.